Current Cardiac Resynchronization Therapy (“CRT”) pacing systems utilize left ventricular (“LV”) leads for pacing the left ventricle and reducing inter-ventricular and intra-ventricular dysynchrony, which leads to improved cardiac output, reduction of dysynchrony, reverse remodeling, less heart failure symptomatology and potentially improved longevity.
In some situations, pacing with an LV lead may cause diaphragmatic stimulation (“DS”). DS causes a patient to have hiccups that occur either intermittently or, in severe cases, every time a pacing impulse is delivered and often requires deactivation of the LV pacing electrode. DS is uncomfortable to the patient and will often require an office or emergency room visit, thereby consuming valuable resources and being an inconvenience for the patient.
Deactivation of LV pacing may lead to worsening of congestive heart failure symptoms, and therefore is not an ideal or even viable option. Often a reduction in current delivery will reduce the frequency of DS, but a method of automatically detecting and troubleshooting DS is needed.